Can home urine LH testing improve egg retrieval?

This study looked at using home urine tests of luteinizing hormone (LH) prior to egg collection. It found that home LH tests were a convenient, cost-saving, and effective method to confirm the final egg maturation prior to collection.

Egg collection is an infertility procedure which is used prior to egg donation or in vitro fertilization (IVF). Medications are used to stimulate the ovaries. When at least one follicle is mature, a hormonal trigger injection is used. This injection causes the body to release luteinizing hormone (LH). High LH causes the egg to complete maturation, after which it is collected.

However, in around 1% of IVF retrievals, no mature eggs are successfully retrieved. An unsuccessful retrieval can happen if the body does not respond to the trigger injection by producing LH.

Blood tests can be used to monitor LH after the trigger shot. If the LH levels are too low, a second trigger shot can be given. However, blood tests are expensive and require another visit to the fertility clinic. Home urine tests of LH are widely available, inexpensive, and convenient. These tests are also known as ovulation predictor kits. It is unclear whether home LH tests can improve egg collection rates.

This study included 359 egg donors. The donors were between ages 18 and 35 and had normal body weights and menstrual cycles. Hormones were used to stimulate the ovaries and prevent an early ovulation. When at least three follicles matured, artificial gonadotropin-releasing hormone (GnRH) was self-injected as a trigger. The donors took a home LH urine test 12 hours later and sent a photo to the researchers. Eggs were collected 36 hours after the trigger injection.

356 donors had a positive home urine LH test. One of these donors did not have any eggs collected, indicating that it was a false positive. The other donors had successful egg collections.

Three tests were negative, and the donors took a blood LH test. One of the home urine tests was a false negative. The other two donors had low blood LH levels. They were given another trigger injection using both GnRH and human chorionic gonadotropin. Their re-scheduled egg collections were successful.

The costs of LH testing were estimated. Giving in-person blood tests to all donors would have cost €14,840 ($16,307), whereas using home tests cost €185.5 ($204).

This study found that home urine LH testing was a cost-efficient method to monitor the success of the GnRH trigger shot during egg retrieval.

Because there was no comparison group, this study could not confirm that home LH monitoring reduced the number of donors with an unsuccessful egg collection. Also, egg donors are a younger and more fertile population than patients undergoing IVF.

Discuss using a urine LH test to monitor egg retrieval with your doctor.